For many diseases that occur almost exclusively in poor countries, hardly any medicines are developed. Although medicines are developed for globally occurring diseases, they are usually too expensive for poor countries, as product development is (re)financed through sales at monopoly prices. For years, there has been a discussion on how to sustainably promote product development in this area and to what extent market mechanisms should be supplemented or even replaced. A closer look at and questioning of individual positions usually reveals a highly complex set of circumstances with local, national and global groups of actors and diverse interconnections of causes and effects.